ABSTRACT
Objective: To find and compare the frequency of caesareansection and its indications among doctors and non-doctorspresented to tertiary-care hospitals of Peshawar city, Pakistan.Methodology: A descriptive cross sectional study wasconducted in four tertiary-care hospital of Peshawar city ofPakistan. Data on Caesarean section frequency and itsindications were collected from the clinical records of 400participants from March to May, 2016.Results: Among the total 400 participants, the frequency ofcaesarean-section was 52.5% (80% in doctors and 25% innon-doctors). A statistically significant difference wereidentified when chi-square test were used to compare thedifference between the two groups (P <0.05). Emergencycaesarean was performed in 120 (57.2%) patients whileElective caesarean was performed in 90 (42.8%). The mostcommon indication for caesarean-section was failedinduction/failed progress of labor (23%).Conclusion: The increased caesarean-section rate observedin doctors community is highly alarming. Our results should betaken into consideration when formulating policies to managethe national trend of increasing caesarean-section rates.
ABSTRACT
Background The role of polymorphism of Angiotensin converting enzyme (ACE) gene and ACE activity in etiopathogenesis, prognosis, and many other clinical parameters in the various form of the cardiovascular disease has been established to some degree of certainty. The pathophysiology of Peripartum cardiomyopathy (PPCM) remains an area of active research. The main aim of our study was to see pattern of ACE- Insertion/Deletion (I/D) allele in PPCM and its implications on left ventricular performance indices. Methods This single-center case-control study included 45 cases and 70 controls. The diagnosis of PPCM was established clinically and echocardiographically. ACE genotyping was done by polymerase chain reaction (PCR) method in all subjects. Results The II, ID, and DD genotype was present in 16, 18 and 11 of subjects with PPCM and 48, 19 and 3 of controls respectively. The odds ratio for ACE-II genotype in cases vs. controls was 0.253 (95% CI = 0.114–0.558; p = 0.007), for that of II genotype was 1.93 (95% CI = 0.86–4.3; p = 0.107) and for DD genotype was 7.225 (95% CI; 1.88–27.6; p = 0.0039). Overall frequency of D allele in cases was significantly higher than controls (odds = 4.25; 95% CI = 2.01–6.7; p = 0.0001). Moreover, ejection fraction, left ventricular volume and linear dimensions were worse in patients with DD genotype. Conclusion ACE DD genotype and overall frequency of D allele is significantly higher in patients with PPCM. Also, the presence of DD genotype is associated with worse systolic performance indices measured echocardiographically.
ABSTRACT
In the last three decades a range of non-invasive biophysical techniques have been developed, of which Magnetic Resonance (MR) has proved to be the most versatile. Its non-invasive and safe nature has made it the most important diagnostic and research tool in clinical medicine. MR Spectroscopy (MRS) is the only technique in clinical medicine that provides non-invasive access to living chemistry in situ. This article focuses mainly on proton MRS in brain and also phosphorus MRS in calf muscle, with particular reference to the pediatric population, the normal spectrum and its use in various disease conditions in the practice of pediatric neurology. Few representative case studies among different disease groups have also been detailed.